[A case of hemolysis induced by lansoprazole]

Hemolytic anemia and possible aplastic crisis with symptoms including jaundice, general fatigue and dark urine developed in a man being treated only by lansoprazole. Five days later, he was treated with antibiotics. The next day, he was admitted to our hospital because of jaundice. On admission, the hemoglobin was 14.0 g/dl, reticulocyte count 8/1000, platelets 79 x 10(9)/l and total bilirubin 12.4 mg/dl (indirect bilirubin 9.5 mg/dl). The above medications were discontinued. The direct Coombs antiglobulin test was positive. Examination of the complement revealed a C3 fiter at the upper limit of normal and an increased C4 and CH50. Three days after admission, he had a severe anemia. The hemoglobin was 3.3 g/DL. We thought it possible that aplastic crisis had followed the hemolytic anemia induced by lansoprazole. He was treated with blood transfusions and corticosteroids. He recovered from anemia within three weeks. Exhaustive studies to identify the cause of the hemolytic anemia were undertaken with negative results. We detected IgG antibody to lansoprazole. We believe that the hemolytic anemia was induced by lansoprazole.